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Role of Nkx2.5 in development and electrophysiology of the mouse heart
Hámor, Peter ; Sedmera, David (advisor) ; Neckář, Jan (referee)
Role of Nkx2.5 in development and electrophysiology of the mouse heart Prague 2016 Peter Hámor, B.S. ABSTRACT The objective of this thesis is to investigate the role of Nkx2.5 gene dosage on electrophysiology of the mouse heart in prenatal stage of its development. The main goal of this work is to search for differences in conduction of electric impulses through the embryonic mouse hearts of different genotype. Special method of capturing the conduction of electric impulse through myocardium, called optical mapping, was used to visualize the electrical activity. Thanks to this method I was able to construct images and videos capturing the spread of the impulse with identification of the beginning of the activation and its direction in the heart. These outputs, or optical maps, help to define anomalies and defects in mutants compared with a normal functioning heart. The thesis focuses on the expression of the transcription factor Nkx2.5 and regulatory components related with the correct formation and physiology of the heart until 9.5 days post coitum. Embryos at this developmental stage were optically mapped and analysed according to their genotype. While the wild type and heterozygote mouse embryos exhibited high degree of similarity, the homozygous mutants were dramatically different. Considering this work...
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Development of cardiovascular system function in patients with a functionally single ventricle
Materna, Ondřej ; Janoušek, Jan (advisor) ; Klásková, Eva (referee) ; Urbanová, Zuzana (referee)
Development of cardiovascular system function in patients with a functionally single ventricle. Abstract Total cavopulmonary connection (TCPC) is the only possible surgical palliative procedure in patients with a functionally single ventricle. It consists of the stepwise anastomosis of both caval veins with pulmonary arteries, creating a unique situation of so-called Fontan circulation, where the separation of the pulmonary and systemic circuit is traded for chronically elevated systemic venous pressure and impaired cardiac output increase during exercise. We aimed to evaluate long-term results and development of exercise capacity in the population of patients with TCPC in the Czech Republic, possible predictors of their survival and functional outcome, as well as analysis of permanent cardiac resynchronization as one of the new treatment options for dysfunction of the single ventricle. We present a retrospective study of all consecutive patients in the Czech Republic identified in the nationwide single-centre institutional database and matched with the National Death Registry and Cardiovascular Intervention Registries. We proved that overall mean survival probability until composite end-point of death, TCPC take- down or indication for a heart transplant was 92.9 % at 20 years after the operation. TCPC...
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Assessment of influence of physiotherapy on cardiopulmonary system in children with congenital heart defect
Kopecká, Anežka ; Radvanský, Jiří (advisor) ; Tetřevová, Lenka (referee)
The aim of the study was to compose and realize physiotherapeutic program for children with congenital heart disease to improve their postural-respirational function and to assess the influence of this program on cardiopulmonary functions of the patients. Our group had five patients with mean age of 15,6 years. Each of them underwent initial examination of the motor system, spirometry and spiroergometric exercise test. Physiotherapeutic program consisted of 8 individual therapies and home-based exercise. Therapy was composed from manual techniques, exercise according to Dynamic neuromuscular stabilisation concept and exercise with inspiratory trainer and improvised PEP system. The final examination was performed in the same manner as the initial one. We compared the results of both examinations, but we found no significant improvement after the physiotherapeutic program.
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Contribution of BNP to prognostic stratification of patients with advanced heart failure.
Hegarová, Markéta ; Málek, Ivan (advisor) ; Bedáňová, Helena (referee) ; Pudil, Radek (referee)
Plasma levels of B-type natriuretic peptide (BNP) are a strong and independent predictor of prognosis in patients with advanced heart failure (CHF). However, the importance of this biomarker has been documented only in CHF of common causes such as dilated or ischemic cardiomyopathy. We hypothesized that BNP can serve as a strong predictor of end-stage CHF in group of patients with advanced CHF due to congenital heart disease (CHD) with the right ventricle in systemic position (SRV). The second hypothesis was that BNP monitoring in patients with implanted left ventricular assist device (LVAD) Heart Mate II could detect serious complications which negatively affect prognosis. We performed a retrospective analysis in 28 consecutive patients with severe systolic dysfunction of the SRV (ejection fraction 23 ± 6%) evaluated as heart transplant (HTx) candidates between May 2007 and October 2014. During a median follow-up of 29 months (interquartile range, 9-50), 14 pts reached primary endpoints of the study (death, urgent HTx, and LVAD implantation). We have considered these events equivalent to end-stage CHF. Using ROC analysis, we identified the first measured value of BNP as the strongest predictor of prognosis with the area under the curve (AUC) of 1.00, followed by the New York Heart Association...
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Role of Nkx2.5 in development and electrophysiology of the mouse heart
Hámor, Peter ; Sedmera, David (advisor) ; Neckář, Jan (referee)
Role of Nkx2.5 in development and electrophysiology of the mouse heart Prague 2016 Peter Hámor, B.S. ABSTRACT The objective of this thesis is to investigate the role of Nkx2.5 gene dosage on electrophysiology of the mouse heart in prenatal stage of its development. The main goal of this work is to search for differences in conduction of electric impulses through the embryonic mouse hearts of different genotype. Special method of capturing the conduction of electric impulse through myocardium, called optical mapping, was used to visualize the electrical activity. Thanks to this method I was able to construct images and videos capturing the spread of the impulse with identification of the beginning of the activation and its direction in the heart. These outputs, or optical maps, help to define anomalies and defects in mutants compared with a normal functioning heart. The thesis focuses on the expression of the transcription factor Nkx2.5 and regulatory components related with the correct formation and physiology of the heart until 9.5 days post coitum. Embryos at this developmental stage were optically mapped and analysed according to their genotype. While the wild type and heterozygote mouse embryos exhibited high degree of similarity, the homozygous mutants were dramatically different. Considering this work...
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